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Upper and lower respiratory tract viral infections and acute graft rejection in lung transplant recipients.
Clin Infect Dis. 2010 Jul 15; 51(2):163-70.CI

Abstract

BACKGROUND

Lung transplant recipients are frequently exposed to respiratory viruses and are particularly at risk for severe complications. The aim of this study was to assess the association among the presence of a respiratory virus detected by molecular assays in bronchoalveolar lavage (BAL) fluid, respiratory symptoms, and acute rejection in adult lung transplant recipients.

METHODS

Upper (nasopharyngeal swab) and lower (BAL) respiratory tract specimens from 77 lung transplant recipients enrolled in a cohort study and undergoing bronchoscopy with BAL and transbronchial biopsies were screened using 17 different polymerase chain reaction-based assays.

RESULTS

BAL fluid and biopsy specimens from 343 bronchoscopic procedures performed in 77 patients were analyzed. We also compared paired nasopharyngeal and BAL fluid specimens collected in a subgroup of 283 cases. The overall viral positivity rate was 29.3% in the upper respiratory tract specimens and 17.2% in the BAL samples (P < .001). We observed a significant association between the presence of respiratory symptoms and positive viral detection in the lower respiratory tract (P = .012). Conversely, acute rejection was not associated with the presence of viral infection (odds ratio, 0.41; 95% confidence interval, 0.20-0.88). The recovery of lung function was significantly slower when acute rejection and viral infection were both present.

CONCLUSIONS

A temporal relationship exists between acute respiratory symptoms and positive viral nucleic acid detection in BAL fluid from lung transplant recipients. We provide evidence suggesting that respiratory viruses are not associated with acute graft rejection during the acute phase of infection.

Authors+Show Affiliations

Division of Pulmonary Medicine, University Hospitals of Geneva, Geneva. paola.soccal@hcuge.chNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20524853

Citation

Soccal, P M., et al. "Upper and Lower Respiratory Tract Viral Infections and Acute Graft Rejection in Lung Transplant Recipients." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 51, no. 2, 2010, pp. 163-70.
Soccal PM, Aubert JD, Bridevaux PO, et al. Upper and lower respiratory tract viral infections and acute graft rejection in lung transplant recipients. Clin Infect Dis. 2010;51(2):163-70.
Soccal, P. M., Aubert, J. D., Bridevaux, P. O., Garbino, J., Thomas, Y., Rochat, T., Rochat, T. S., Meylan, P., Tapparel, C., & Kaiser, L. (2010). Upper and lower respiratory tract viral infections and acute graft rejection in lung transplant recipients. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 51(2), 163-70. https://doi.org/10.1086/653529
Soccal PM, et al. Upper and Lower Respiratory Tract Viral Infections and Acute Graft Rejection in Lung Transplant Recipients. Clin Infect Dis. 2010 Jul 15;51(2):163-70. PubMed PMID: 20524853.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Upper and lower respiratory tract viral infections and acute graft rejection in lung transplant recipients. AU - Soccal,P M, AU - Aubert,J-D, AU - Bridevaux,P-O, AU - Garbino,J, AU - Thomas,Y, AU - Rochat,T, AU - Rochat,T S, AU - Meylan,P, AU - Tapparel,C, AU - Kaiser,L, PY - 2010/6/8/entrez PY - 2010/6/8/pubmed PY - 2010/9/21/medline SP - 163 EP - 70 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin. Infect. Dis. VL - 51 IS - 2 N2 - BACKGROUND: Lung transplant recipients are frequently exposed to respiratory viruses and are particularly at risk for severe complications. The aim of this study was to assess the association among the presence of a respiratory virus detected by molecular assays in bronchoalveolar lavage (BAL) fluid, respiratory symptoms, and acute rejection in adult lung transplant recipients. METHODS: Upper (nasopharyngeal swab) and lower (BAL) respiratory tract specimens from 77 lung transplant recipients enrolled in a cohort study and undergoing bronchoscopy with BAL and transbronchial biopsies were screened using 17 different polymerase chain reaction-based assays. RESULTS: BAL fluid and biopsy specimens from 343 bronchoscopic procedures performed in 77 patients were analyzed. We also compared paired nasopharyngeal and BAL fluid specimens collected in a subgroup of 283 cases. The overall viral positivity rate was 29.3% in the upper respiratory tract specimens and 17.2% in the BAL samples (P < .001). We observed a significant association between the presence of respiratory symptoms and positive viral detection in the lower respiratory tract (P = .012). Conversely, acute rejection was not associated with the presence of viral infection (odds ratio, 0.41; 95% confidence interval, 0.20-0.88). The recovery of lung function was significantly slower when acute rejection and viral infection were both present. CONCLUSIONS: A temporal relationship exists between acute respiratory symptoms and positive viral nucleic acid detection in BAL fluid from lung transplant recipients. We provide evidence suggesting that respiratory viruses are not associated with acute graft rejection during the acute phase of infection. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/20524853/Upper_and_lower_respiratory_tract_viral_infections_and_acute_graft_rejection_in_lung_transplant_recipients_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1086/653529 DB - PRIME DP - Unbound Medicine ER -